Journal of oral biology and craniofacial research · 2025
Clinical effectiveness and cost-effectiveness of two sodium fluoride varnish systems in preventing dental caries in children: a randomized clinical trial.
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Khairnar Mahesh R, Naveen Kumar P G, Sabharwal Harloveen, Jadhav Sachin Kumar, Badnaware Sheetal, Shukla Neha, Kusumakar Ananta, Akram Zainab, S Savitha Priyadarsini, Ghodela Ridhi
Аннотация
BACKGROUND: Dental caries frequently affects first permanent molars soon after eruption due to their anatomical susceptibility. Fluoride varnish is a widely accepted preventive measure; however, different formulations vary in fluoride retention and cost. Evidence comparing both clinical outcomes and economic value of available varnishes in children remains limited.
AIM: To compare the clinical effectiveness and cost-effectiveness of resin-based and alcohol-based 5 % sodium fluoride varnishes in preventing dental caries in permanent first molars of high-risk schoolchildren.
DESIGN: A double-blind, parallel-arm randomized controlled trial was conducted among 84 children (330 M) aged 6-8 years from a private school in Varanasi, India. Participants received either resin-based varnish (163 teeth) or alcohol-based varnish (167 teeth) at six-month intervals. Caries incidence was assessed at baseline, 6, 12, 18, and 24 months using ICDAS-II. A financial cost-benefit perspective was adopted, considering direct material and application costs borne by the provider and estimated restorative treatment savings for patients. Appropriate statistical tests were used for analysis (α = 0.05).
RESULTS: Caries incidence remained low in both groups after 24 months (resin-based: 7.4 %; alcohol-based: 7.8 %; p = 0.961). No significant differences were found in early or advanced lesions at any interval (p > 0.05). ITT and Per-protocol analyses revealed negligible effect sizes (Cliff's Delta ≤0.05). Cost-effectiveness analysis demonstrated that the alcohol-based varnish produced ₹62.22 savings per ₹1 spent, compared to ₹8.47 in resin-based group. The cost to save ₹100 in future restorative expenses was ₹1.61 (alcohol-based) and ₹11.80 (resin-based).
CONCLUSION: Both varnishes were equally effective, but alcohol-based varnish was substantially more cost-effective, making it a suitable choice for large-scale preventive programs in resource-constrained settings.
AIM: To compare the clinical effectiveness and cost-effectiveness of resin-based and alcohol-based 5 % sodium fluoride varnishes in preventing dental caries in permanent first molars of high-risk schoolchildren.
DESIGN: A double-blind, parallel-arm randomized controlled trial was conducted among 84 children (330 M) aged 6-8 years from a private school in Varanasi, India. Participants received either resin-based varnish (163 teeth) or alcohol-based varnish (167 teeth) at six-month intervals. Caries incidence was assessed at baseline, 6, 12, 18, and 24 months using ICDAS-II. A financial cost-benefit perspective was adopted, considering direct material and application costs borne by the provider and estimated restorative treatment savings for patients. Appropriate statistical tests were used for analysis (α = 0.05).
RESULTS: Caries incidence remained low in both groups after 24 months (resin-based: 7.4 %; alcohol-based: 7.8 %; p = 0.961). No significant differences were found in early or advanced lesions at any interval (p > 0.05). ITT and Per-protocol analyses revealed negligible effect sizes (Cliff's Delta ≤0.05). Cost-effectiveness analysis demonstrated that the alcohol-based varnish produced ₹62.22 savings per ₹1 spent, compared to ₹8.47 in resin-based group. The cost to save ₹100 in future restorative expenses was ₹1.61 (alcohol-based) and ₹11.80 (resin-based).
CONCLUSION: Both varnishes were equally effective, but alcohol-based varnish was substantially more cost-effective, making it a suitable choice for large-scale preventive programs in resource-constrained settings.